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World Journal of Surgery

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01-07-2016 | Original Scientific Report

Comparison of the Outcomes of Patients with Hepatocellular Carcinoma and Portal Hypertension After Liver Resection Versus Radiofrequency Ablation

Authors: Noboru Harada, Ken Shirabe, Takashi Maeda, Hiroto Kayashima, Shintaro Takaki, Yoshihiko Maehara

Published in: World Journal of Surgery | Issue 7/2016

Abstract

Background

The aim of this study was to compare the outcome of patients with hepatocellular carcinoma (HCC), Barcelona Clinic Liver Cancer (BCLC) stages 0 and A, and portal hypertension (PHT) who underwent liver resection (LR) or radiofrequency ablation (RFA).

Methods

The study population consisted of 121 patients with PHT and HCC of BCLC stage 0 and A who underwent LR (n = 81) or RFA (n = 40). To reduce bias in patient selection, the different covariate distributions in two groups were adjusted using inverse probability treatment weighting (IPTW). The prognostic outcomes of LR- and RFA-treated patients were then analyzed.

Results

Before IPTW adjustment, the 5-year overall survival (OS) of LR and RFA patients was comparable. Five-year recurrence-free survival (RFS) was significantly better in the LR group than in the RFA group (P < 0.0001). Multivariate analysis showed that RFA was an independent predictor of worse RFS (P = 0.0004). The local recurrence rate was higher in the RFA than in the LR group, with recurrences in each group tending to be treated with the same modality as initially. After IPTW adjustment, the OS of patients in the LR and RFA groups did not significantly differ, whereas the RFS of the LR group remained significantly better than that of the RFA group (P = 0.00014). However, the RFA group had fewer postoperative complication rates and a shortened length of hospital stay.

Conclusions

By reducing postoperative complications, LR may be a treatment option for patients with BCLC stage 0 or A HCC and PHT.

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Title: Comparison of the Outcomes of Patients with Hepatocellular Carcinoma and Portal Hypertension After Liver Resection Versus Radiofrequency Ablation
Authors: Noboru Harada
Ken Shirabe
Takashi Maeda
Hiroto Kayashima
Shintaro Takaki
Yoshihiko Maehara
Publication date: 01-07-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 7/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3465-6

At a glance: The STEP trials

Springer Medicine

Comparison of the Outcomes of Patients with Hepatocellular Carcinoma and Portal Hypertension After Liver Resection Versus Radiofrequency Ablation

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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